A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?

Atrial flutter

Atrial fibrillation

Unstable angina

Premature atrial contractions (PACS)

Answer and Explanation

The Correct Answer is B

A. Atrial flutter typically presents with a regular atrial rate (usually around 250-350 beats per minute) and a characteristic "sawtooth" pattern of flutter waves (F-waves) on the ECG. This condition would not present with irregular ventricular rates and is less likely based on the ECG findings described.

B.   Atrial fibrillation is identified by an irregularly irregular rhythm and the absence of P-waves on the ECG, which is replaced by erratic activity.
C.   Unstable angina presents with chest pain or discomfort due to reduced blood flow to the heart muscles, usually related to atherosclerotic plaque rupture or erosion. It does not cause the ECG findings described (absence of P-waves and irregular ventricular rate).
D.   PACs are early atrial depolarizations that can cause palpitations but do not typically result in the absence of P-waves or irregular ventricular rates as described in the scenario.

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Correct Answer is B

Explanation

A. Splenectomy is not a standard treatment for myasthenia gravis. The spleen's role is primarily related to immune function and blood filtration rather than the pathophysiology of MG.
B. Thymectomy is a surgical procedure that involves the removal of the thymus gland. The thymus gland plays a role in the development and regulation of the immune system. In some cases of myasthenia gravis, especially in younger patients or those with thymoma (a tumor of the thymus gland), thymectomy can lead to improvement or remission of symptoms. This procedure is considered in cases where myasthenia gravis is refractory to medication or in cases associated with thymoma.
C. Appendectomy is the surgical removal of the appendix and is not a treatment for myasthenia gravis. The appendix is not implicated in the pathophysiology of MG.
D. Cholecystectomy is the surgical removal of the gallbladder and is performed for conditions related to the gallbladder, such as gallstones or inflammation. It is not indicated for the treatment of myasthenia gravis.

A. Provide the client with an electric shaver for grooming. B. Move the client to a negative pressure isolation room. C. Encourage the client to select cooked vegetables rather than a salad for their lunch tray. D. Educate the client to dab their nose, rather than forcefully blow their nose.

Correct Answer is A

Explanation

A. This option is appropriate because the client's low white blood cell count (3,100/mm³) suggests they are at risk for infection due to chemotherapy-induced immunosuppression. Using an electric shaver reduces the risk of cuts and nicks that could potentially lead to infections.

B. This option is not necessary based on the client's current lab results. Negative pressure isolation rooms are typically reserved for clients with severely compromised immune systems, such as those with very low neutrophil counts (neutropenia). A white blood cell count of 3,100/mm³ is within a range where standard precautions are usually sufficient.
C. This option addresses food safety precautions for clients with neutropenia (low white blood cell count). Raw vegetables, including salads, have a higher risk of harboring bacteria that could cause infections. Therefore, cooked vegetables are safer for clients with compromised immune systems.
D. This option is appropriate because chemotherapy-induced thrombocytopenia (low platelet count of 280,000/mm³) increases the risk of bleeding. Forceful blowing of the nose can traumatize the nasal mucosa and increase the risk of nosebleeds. Dabbing the nose gently is a safer method to avoid nosebleeds.

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A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has myasthenia gravis which has not responded to medication treatments. Which of the following surgeries can treat myasthenia gravis?

Correct Answer is B

Explanation

A nurse is caring for a client who is receiving chemotherapy. The client's most recent lab results show a white blood cell count of 3,100/mm3, and a platelet count of 280,000/mm3. Based on these lab results, which nursing action is appropriate for this client?

Correct Answer is A

Explanation

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A client in an urgent care clinic is complaining of heart palpitations, fatigue, and shortness of breath. A 12-lead electrocardiogram (ECG) shows no discernable P-waves, and an irregular ventricular rate. The nurse should understand that this finding represents which of the following conditions?